One eye appearing bigger than the other is one of those things that can be a source of curiosity. Sometimes this can change to worry.
What causes one eye to appear larger than the other? Is it serious?
The answer: It depends!
One eye may appear larger for several reasons, some more serious than others.
In this article, we will cover some conditions that cause uneven eyes and some tell-tale symptoms you should watch out for.
What are uneven or asymmetrical eyes?
Uneven or asymmetrical eyes are a condition where one eye looks larger than the other. One will look bulgier, swollen, and overcrowded in comparison with the other.
This might be due to the unequal size of eyeballs. It might be also because of other things that differ from individual to individual such as age, genetics, etc.
Now, it’s a normal thing to have uneven eyes. Most of the time, you’ll be the only person who can spot the difference in your two eyes.
On several occasions, uneven eyes may come as a result of non-medical reasons.
Only a few medical conditions can cause you to have one eye bigger than the other.
Causes of Uneven Eyes
You may develop uneven eyes because of several factors.
Some of the most common medical ones include:
1. Grave’s Disease
The thyroid is a gland in the neck that produces hormones.
Grave’s disease happens when this gland becomes overactive and starts producing too much hormone.
It is also known as hyperthyroidism.
This can cause one eye to appear bigger than the other. This is because of the swelling around the eyes due to fluid retention. Fluid retention is normally caused by high levels of circulating thyroxine.
A common symptom associated with Grave’s Disease is bulging eyes or proptosis. (but not all patients will experience it)
2. Genetics/Natural Facial Asymmetry
Do you have a family history of one eye appearing bigger than the other?
If yes, then this may be due to genetics. This is because it can run in families (but not in all cases).
Several different genes can cause eyes to appear uneven if mutated or otherwise disrupted.
If you have someone in your family with asymmetrical eyes, then someone else may get them too.
As you grow older, your face may shift and change its shape.
This is because of the natural changes in weight that happen as we get older.
These natural facial changes can cause one eye to appear bigger than the other. This is especially if both eyes do not share similar proportions.
This applies usually when asymmetry becomes apparent after age 30 or 40. (it’s more common among adults, rather than children)
There are many factors behind this including heredity, but there isn’t much evidence on them so far.
Enophthalmos is a condition characterized by having recessed eyes.
This means that the socket of the eye has shrunk since birth (or sometime during your life).
Some people may develop this condition due to certain factors including:
- maxillary sinus tumors
- bony defects
- Paget disease
- silent sinus syndrome
This can cause one eye to appear bigger than the other because it lacks a proper orbital rim support structure around its orbit or cavity.
Usually, enophthalmos occurs on just one side. Sometimes, it can affect both sides of the case is severe enough.
In some cases, enophthalmos only affects children who’ve not fully grown into their adult appearance yet.
Do you see one eye that looks bigger than the other?
This is a sign of proptosis. It happens when one eyeball protrudes abnormally from its usual position. It extends further forward from its socket than the other eyeball.
There are many causes for this including:
- thyroid disease
- Grave’s disease
- tumors (rare)
- infections (rare)
6. Lifestyle Factors
Do you spend a lot of time in the sun?
Too much exposure to ultraviolet radiation can cause your skin and eyes to swell. This is usually known as pterygium. This usually affects the area around both eyes)
This may be another factor that contributes to one eye appearing bigger than the other. It happens when there is an increase in blood flow due to inflammation within this region. The extra swelling can also affect its appearance over time by making it look larger or puffier than usual.
Another lifestyle risk is smoking. Nicotine can affect the blood flow to your eyes. This makes it harder for them to function properly and can cause droopy eyelids or ptosis.
Ptosis happens when your eyelids droop due to muscle weakness or fatigue in this area. This causes it to hang lower than normal. This happens because they’re not held up by strong muscles anymore.
Your face will look different with ptosis as it can cause asymmetry. The sagging skin can also make your brows appear heavier on one side compared to the other.
There are several causes for ptosis including:
- neurological defects
This is when the medial canthal tendon attaches to a single eyelid, with both portions of skin covering the eye. Because this creates one solid piece of tissue, it may make one eyeball appear larger than the other.
In cases where there’s a significant difference in size between two eyes that isn’t accompanied by another problem, surgery could help balance out your face. It can help create symmetry as well as improved vision.
A stroke happens when there’s damage to your brain. This occurs after a certain blood vessel gets blocked, causing a lack of oxygen in that area.
This can cause ptosis as well as enophthalmos which affects only one side. Still, the symptoms depend on what part of the brain got affected. These symptoms often affect both eyes simultaneously and usually worsen over time.
Some causes for these include:
- meningitis or viral infections
- diabetes mellitus
- high blood pressure
- smoking habits or high cholesterol levels in the body
10. Bell’s Palsy
Bell’s Palsy happens when your facial nerve gets damaged.
This can lead to:
- drooping eyelids and eyebrows which affects both eyes simultaneously (asymmetry in appearance)
- paralysis of the face muscles (difficulty closing one eye or smiling on just one side)
- incomplete closure during blinking involving only a portion of the affected muscle(s). This can result in exposure keratitis due to tear pooling under an open lid
- dry mouth, nose, and throat that requires you to constantly sip water or use medication for hydration
- difficulty eating solid food because it causes drooling as well as chewing difficulties
These symptoms usually last for a few weeks. However, some cases require long-term follow-ups and treatment that can include surgery as well.
And unfortunately, there’s no permanent cure yet for Bell’s Palsy. Its recovery’s based on the severity of the damage.
Symptoms of uneven eyes
Symptoms can vary for people with uneven eyes.
If the cause is a bulging eye from trauma or infection, the common symptoms may include:
- Double vision
- Pulsation behind the bulging eye
- Loss or decrease of vision
- Eye pain or redness
General signs will have:
- one pupil appears larger than the other
- your lashes touch only halfway while blinking
- the skin around either eye sags more significantly
- swelling around the eyes
These shouldn’t last more than two weeks or longer. If it does, then it may indicate an underlying health issue that requires medical attention!
If you have been previously diagnosed with Bell’s Palsy, seek medical advice immediately.
There are several treatment options for people with one eye appearing bigger than the other.
1. Orbital Decompression Surgery
This procedure reduces pressure on the nerve that controls eye muscle movement. It works to reduce pain and improve cosmetics, or appearance.
The surgery’s performed with an incision behind the eyeball. The surgeon will remove some bone and tissue from around the nerve to stop pressure on it.
Surgery time ranges from 1-3 hours depending on how much work’s needed. After this procedure, patients need special eye drops for weeks/months post-surgery. This can cause redness and irritation at times.
You’ll also have stitches under your eyelid(s) that dissolve over time as they heal naturally. This happens in about a week.
2. Botox Injections
Unlike Orbital Decompression Surgery, Botox injections are only for cosmetic purposes.
This is a non-invasive procedure that can get done in under twenty minutes per eye.
The goal of using this treatment option is to reduce or eliminate bags and wrinkles around your eyes. Botox does this by paralyzing muscles temporarily.
It works best when the cause of your uneven eyes is droopy eyelids or excess skin fold.
Note: It’s important not to have surgery and get these injections at the same time. This is because the healing process differs with each and might bring complications.
If you’re dealing with excess skin and fat around your eyes, this may be the best way to go.
A blepharoplasty is a popular cosmetic surgery that removes some skin from either upper or lower lids. It also removes underlying tissues such as fat pads and muscles.
This treatment can improve both appearance and function of droopy eyelids or sagging eyebrows.
The recovery time after this procedure takes about two weeks before you can get back on your feet again.
4. Brow Lift Surgery
A Brow Lift surgery is another option that you can explore.
This surgery does not change the size of one eye over the other. Instead, it helps correct any asymmetry as a result of sagging skin or drooping eyebrows from aging.
After a day or two, you would see results in terms of how your eyes look. Your surgeon might also recommend some follow-up appointments. These will be mainly for touch-ups and other examinations as well.
If your case does not require surgery, then you can try some home remedies.
The use of makeup can be one of the best ways to make your eyes appear more symmetrical. You can straighten out uneven brows using highlights and contours.
If the cause of your uneven eyes is due to swelling from an injury, then:
- Place ice on both sides of your face where the swelling is.
- Apply donut-shaped pads around the affected area(s) with cucumber juice or tea bags containing chamomile or lavender.
- Use oatmeal as a facial mask by adding water until thick paste forms. Apply for 15 minutes then rinse off.
- Apply a cool compress to the swollen areas of your face for 20 minutes twice a day.
If you have allergies, then:
- Take antihistamines to relieve the symptoms of your allergy and reduce swelling in the eyes. Do not use if pregnant or breastfeeding unless recommended by a doctor
- Use eye drops prescribed by your ophthalmologist (eye doctor) that reduce itching from allergic reactions.
You shouldn’t get alarmed if your one eye looks bigger than the other. It’s a normal trait that passes on to many people without them knowing.
If your case is because of medical issues, then seek medical advice as soon as you can.